New perspectives of recurrent atrial fibrillation prevention in coronary heart disease patients

Abstract

Aim. То assess clinical effectiveness of simvastatin in coronary heart disease (CHD) patients with paroxysmal atrial fibrillation (AF). Material and metliods. Thirty-two CHD patients (mean age 53+2,7 years) with paroxysmal AF and cardioversion-restored sinus rhythm were randomized into two groups. Group I (n=12) included patients receiving standard antiarrhythmic therapy and simvastatin. Group II - only standard therapy. Examination methods included: physical examination; standard 12-lead ECG with QT interval, QT dispersion (QTd), corrected QT (QTc), and QTc dispersion measurement; ECG-monitoring with assessment of heart rate (HR), incidence and features of extrasys toles, and number of ischemic ST depression episodes. laboratory tests included lipid profile and hepatic transaminase levels assessment. Results. During the follow-up period, recurrent AF incidence was significantly lower (p<0,001) in Group I (27%), comparing with Group II (76%). Monitoring results demonstrated some benefits, e.g., decreased HR and reduced sinus tachyarrhythmia episode rate in simvastatin group, as well as antiarrhythmic and anti-ischemic effects. QTc duration and dispersion dynamics was statistically significant in Group I only (p<0,001). Conclusion. As statins demonstrate anti-inflammatory activity and may affect pathogenetic AF mechanisms, their administration can be regarded as a new strategy for AF prevention.

Keywords

• statins
• atrial fibrillation
• prevention